This semester, Global Health Professor Kearsley Stewart’s HIV/AIDS Narratives class is tackling a new project using Rubenstein Library collections. Working with poet and writer Kelley Swain, students are exploring the Maria de Bruyn Papers, a rich collection of global health materials related to de Bruyn’s work as a medical anthropologist globally addressing HIV/AIDS.

Students in Stewart’s HIV/AIDS Narratives explore the de Bruyn papers.

Students are delving into the de Bruyn papers as they work with Kelley Swain and learn more about the Humement project, based on the work of artist Tom Phillips, and apply this to their class. You can find details about their work in a recent DGHI newsletter. (A very important note: Original materials were not altered. Students spent an afternoon selecting original documents to scan and reproduce for their projects.)

In conjunction with the work of Professor Stewart’s class, the History of Medicine Collections is co-sponsoring an event with the Franklin Humanities Institute, the Health Humanities Lab, and the Trent Center for Bioethics, Humanities & the History of Medicine to recognize World AIDS Day. The event will be held on Wednesday, November 30, from 3:00 – 5:00 p.m. with a reception to follow, held in Room 153, the Holsti-Anderson Family Assembly Room of the Rubenstein Library. The event is free and open to the public.

Speakers will include Maria de Bruyn, Alicia Diggs of North Carolina AIDS Action Network (NCAAN), poet and writer Kelley Swain, and students from Professor Stewart’s HIV/AIDS Narratives class.

An exhibit in the Josiah Charles Trent History of Medicine Room will highlight a small sample of what can be found in the Maria de Bruyn papers. In addition, students in Professor Stewart’s class will be showcasing their work on the Student Wall in Perkins Library in December and January.

Among the 20,000 books and 4,000 manuscripts that together comprise the History of Medicine Collections at Duke’s David M. Rubenstein Rare Book and Manuscript Library—not to mention the collection’s hundreds of medical instruments and artifacts—is a large, leather-bound account ledger in folio kept by Hugh Mercer, an apothecary in Fredericksburg, Virginia, from 1771 to 1775.

Born in Aberdeen, Scotland, in 1725, Mercer went on to study medicine at Marischal College, graduating in 1744 before taking up a post as an assistant surgeon in the army of Charles Edward Stuart, better known as Bonnie Prince Charlie.

With the Scots’ defeat at Culloden in 1746, Mercer fled to America, arriving in Philadelphia in 1747. Mercer settled in what is now Mercersburg, Pennsylvania, where he practiced medicine for eight years. During the Seven Years’ War, Mercer served in the British army, where he met and befriended Colonel George Washington. Following his service, Mercer resettled in Fredericksburg, Virginia, a decision no doubt influenced by Washington.

It was in Fredericksburg that Mercer, along with his business partner and fellow physician Ewen Clements, opened his apothecary shop. On May 28, 1771, in the Virginia Gazette, Mercer and Clements, “partners in the practice of physic and surgery,” announced that they had “opened a shop on the main street, opposite to Mr. Henry Mitchell’s store, furnished with a large assortment of drugs and medicines of the best quality, just imported from London; where Gentlemen of the profession and others may be supplied at easy rates, for ready money.” Together, Mercer and Clements compounded and dispensed medicines, diagnosed patients’ disorders, and prescribed and administered treatments.

The ledger kept by Mercer, which documents the history of his practice from 1771 to 1775, is a microcosm of the social and intellectual worlds of eighteenth-century Virginia. It contains entries for more than three hundred different accounts. Below each entry, Mercer meticulously documented his visits with patients, the medicines he dispensed, the treatments he prescribed, as well as the fees he charged.

An entry in Mercer’s ledger for the account of Colonel Fielding Lewis, a Fredericksburg merchant and George Washington’s brother-in-law. Click image to enlarge.

Among Mercer’s many patients were Mary Ball Washington, George Washington’s mother; Betty Washington Lewis, George Washington’s sister, and her husband Colonel Fielding Lewis; Thomas Ludwell Lee; John, Henry, and William Fitzhugh; and Mann Page. Mercer often noted the occupations of his patients, who ranged from merchants, planters, and gentlemen to tradesmen, schoolmasters, undertakers, and stage players. A number of women, many of them widows, kept their own accounts with Mercer. Also among Mercer’s patients were the enslaved men, women, and children whose visits were charged to their masters’ accounts.

Mercer kept a running index in the back of the ledger for each of his accounts. Click image to enlarge.

Mercer offered a range of treatments and services to his patients, from bleeding, purging, and pulling teeth to blistering, vomiting, and setting broken bones. He likewise dispensed a variety of compounds and medicines. These included saline mixtures, purging pills, febrifuge drops, liquid laudanum, balsam honey, magnesia, glauber salts, and stomach elixirs. In keeping with the medical science of his day, Mercer’s treatments were aimed at restoring the delicate balance of his patients’ four humors—black bile, yellow bile, phlegm, and blood—and ensuring equilibrium among the body’s solids and fluids.

In all, Hugh Mercer’s ledger offers a unique window into the prevailing medical beliefs and practices of eighteenth-century Virginia society and represents only a sample of the Rubenstein Library’s rich collection in the history of medicine.

The David M. Rubenstein Rare Book & Manuscript Library is now accepting applications for our 2017-2018 travel grants. If you are a researcher, artist, or activist who would like to use sources from the Rubenstein Library’s research centers for your work, this means you!

The grants are open to undergraduate and graduate students, faculty, independent scholars, artists, and activists who live more than 100 miles from Durham, NC, and whose research projects would benefit from access to collections held by one of the centers listed above.

More details—and the grant application—may be found on our grants website. Applications must be submitted no later than 5:00 PM EST on January 31, 2017. Recipients will be announced in March 2016.

Join the Trent History of Medicine Lecture Series for our next lecture by Cali Buckley on “The History and Legacy of Ivory Anatomical Manikins.” Ivory anatomical models comprise a little-known set of objects that were popular with male doctors of the late 17th- and 18th-centuries. Their narrative is currently being revised in light of a history of questionable assumptions. Though small and largely inaccurate, the story of anatomical manikins reveals how the politics of medicine impresses meaning on medical objects – often transcending the needs of the scientific community. Ms. Buckley will present on her current hypotheses as well as the process by which medical objects can be examined according to social history, connoisseurship, and material culture.

Cali Buckley is a Ph.D. candidate in art history at Penn State University. She received a Fulbright U.S. Student Award that allowed her to spend the 2015–16 academic year in Germany working on her dissertation, “Early Modern Anatomical Models and the Control of Women’s Medicine.”

The talk will be held in the Holsti-Anderson Family Assembly Room, Room 153, of the Rubenstein Library at Duke University. All are welcome to attend. Sponsored by the History of Medicine Collections.

During my tenure as the Research Services Graduate Intern at the Rubenstein Library, I had the great fortune of exploring the fascinating history of the four humors, a topic that is far afield from my doctoral research on the culinary history of New Orleans. Setting aside my copy La Cuisine Creole, I picked up a first edition of Henry Peacham’s Minerva Britanna (1612) and paged through whimsical woodcuts that featured long swordsmen, lions, and laurelled lutenists. Although New Orleans’ history is bedazzled by myth, that of the four humors seems surreal, emerging out of a world occupied by dragons and vengeful gods. What resulted from my foray into this cosmos is a new exhibit in the Josiah Charles Trent History of Medicine Room, entitled, “A Delicate Balance: Understanding the Four Humors.”

The four humors were a means of analyzing a person’s disposition as well as her physical, mental, and emotional health. Within this belief system, every person had a unique humoral composition that shaped her behavior, appearance, and interactions with the broader world. Visualized as bodily fluids whose levels were constantly in flux, Hippocrates named the four humors black bile, phlegm, yellow bile, and blood. Each humor was paired with one of the four elements of earth, water, fire, and air and was assigned qualities of cold, moist, dry, and hot. Their influence on the body changed with external factors like the time of day, the season of the year, and the age of a person.

The origins of this medical philosophy and practice are attributed to the Indian Ayurveda system of medicine as well as ancient Greek, Roman, and Islamic physicians. This holistic approach to human health was pervasive in the Medieval and Early Modern periods and remained a common means of assessing and treating the human body until major advancements transformed medical practices in the mid-nineteenth century.

Prior to these innovations, medical practitioners sought to help ailing patients by restoring the delicate balance of the humors and did so through techniques such as bloodletting and herbal remedies. The new exhibit features a bloodletting fleam that a physician would have used to lance open a vein to remove excess blood from the body so as to bring equilibrium to a patient’s internal fluids. In the United States, doctors employed bloodletting through the Civil War to treat soldiers suffering from infection and fever.

Consumption also played a major role in balancing the four humors. Throughout Early Modern Europe, for example, physicians kept gardens with plants that were assigned to a particular humor. They believed that patients could restore their bodies to full health by consuming carefully crafted herbal remedies comprised of stems, leaves, fruits, and nuts. Practitioners organized gardens to represent the potency of medicinal plants. Some of these historic gardens still exist today. The circular Minerva Garden in Salerno Italy, for example, is divided into four quadrants representing the four humors with the most potent plant life at the center of the garden. This garden is a physical embodiment of the healing powers ascribed to plants within the humoralist system.

Minerva Garden, Salerno Italy. Photo credit: Ashley Rose Young.

In the next few weeks, I encourage you to visit the Josiah Charles Trent History of Medicine Room on the first floor of the Rubenstein Rare Book & Manuscript Library so as to glimpse into the rich history of the four humors and their impact on medical practices in the Early Modern period through today.